Pros and Cons of Family Practice

Hey everyone. I am interested in Family Practice and have been gaining some information about it. I have some family friends who are family practice physicians. I was wondering what were some of your personal opinions were about the pros and cons of family practice? I am just interested in some various other perspectives of the profession. Thanks guys.

Pros
-Short residency
-Lots of programs to reimburse you for school if you will work for them

Cons
-Low pay
-Crappy hours
-Questionable level of challenge in day to day work

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DKM you are a respiratory therapist and Premed who has yet to even apply to medical school.

Your concept on the day to day practice life of a physician is limited to episodes of ER and the few minutes a day you might spend interacting with a doc.

Of you 8,000 plus posts there have been but a handful that have been useful. I dont understand why you continue to post and give information, much of which is either wrong or has no basis of experience behind it.

It almost sounds like you're trying to start another MD/DO debate...but I'll bite anyway. FP's (whether DO or MD) who do a lot of procedures make the most money. It doesn't matter what the initials after your name are. For example, FP's who do OB typically make 40 to 80 thousand a year more...but they also pay higher malpractice-- if they pay it at all.

Clever, but that wasn't my question. Do D.O.s who don't use O.M.M. and hence practice like M.D.s, make as much as their M.D. peers?

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No. On average DOs who dont use OMM make far less then MDs. Patients wont make appointments with them, MDs wont talk to them and they cant write prescriptions. Hell, nurses wont even bang a DO if there is an MD around. Sad world.

For all the dumb $hit you post Riker, you are seriously asking this? Unbelievable.

No. On average DOs who dont use OMM make far less then MDs. Patients wont make appointments with them, MDs wont talk to them and they cant write prescriptions. Hell, *********************** there is an MD around. Sad world.

For all the dumb **** you post Riker, you are seriously asking this? Unbelievable.

Hey everyone. I am interested in Family Practice and have been gaining some information about it. I have some family friends who are family practice physicians. I was wondering what were some of your personal opinions were about the pros and cons of family practice? I am just interested in some various other perspectives of the profession. Thanks guys.

CONS
- Reimbursement is among the lowest in medicine
- Hours can be long depending on type of practice
- Limited scope in some hospital settings (ICU)
- No shortage of patients usually means TOO MANY patients!

Overall its a great field and most people who go into FP are very happy with it. Spending some time in an FP office to see what the day is like might be a good idea.

CONS
- Reimbursement is among the lowest in medicine
- Hours can be long depending on type of practice
- Limited scope in some hospital settings (ICU)
- No shortage of patients usually means TOO MANY patients!

Overall its a great field and most people who go into FP are very happy with it. Spending some time in an FP office to see what the day is like might be a good idea.

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I'm finishing up FP residency, and this is pretty much right on par with what I see. I would add to the pros that you can pretty much find a job anywhere, that goes with no shortage of patients.

The limited scope in the hospital setting is becoming more of a reality than I would like. It is getting harder to find a practice which still does all of its own inpatient work. The majority of employment opportunities I've looked into do not involve inpatient work. they are out there, but getting more scarce.

Also, due to the low reimbursement, the pressures to see a high volume of patients in a limited time is frustrating. Few graduates are in a position to start their own practice and practice their own style straight out of residency. Most need to hit the pavement and enter into an employment model where your schedule and marketing strategy is dictated by corporate bean counters who only see things in dollars and cents, and even then still don't quite "get it".

Speaking for myself personally, my own contract negiotation and employment process has been a long, drawn out, soul sucking, pride swallowing affair wherein more attention is given to market research and dysfunctional corporate dynamics than my own clinical skill and performance as a resident. This is probably true in every field, but in Family Medicine it seems that the intersection between money and medicine is even more pronounced given the low reimbursement and thin margin of error for reaching your financial bottom line.

So the low reimbursement is probably the biggest CON, mostly because it makes it hard to practice medicine the way you would like. When people say, so what, they can still comfortably live off of $120,000 a year, they are right from that standpoint. What makes low reimbursement a CON is not the salary, its the way it limits how you practice medicine.

In summary, I agree with JP's post. I just wanted to clarify why low reimbursement is a CON. I'm optimistic that this will change. Some manner of healthcare reform is on the horizon, anyone who follows politics will tell you that, and historically primary care has always benefitted financially from healthcare changes which broaden public access to healthcare. (I'm not gonna debate this statement in this thread).

BTW, The complexity of medical issues you deal with on a day to day basis equals or exceeds every other specialty. Any Family Doc who tells you FP is not challenging is either lazy or flat out doesn't know what they are doing, and is blissfully unaware of the complexity in keeping people healthy and treating multiple diseases and organ systems in a holistic and ongoing manner.

I'm finishing up FP residency, and this is pretty much right on par with what I see. I would add to the pros that you can pretty much find a job anywhere, that goes with no shortage of patients.

The limited scope in the hospital setting is becoming more of a reality than I would like. It is getting harder to find a practice which still does all of its own inpatient work. The majority of employment opportunities I've looked into do not involve inpatient work. they are out there, but getting more scarce.

Also, due to the low reimbursement, the pressures to see a high volume of patients in a limited time is frustrating. Few graduates are in a position to start their own practice and practice their own style straight out of residency. Most need to hit the pavement and enter into an employment model where your schedule and marketing strategy is dictated by corporate bean counters who only see things in dollars and cents, and even then still don't quite "get it".

Speaking for myself personally, my own contract negiotation and employment process has been a long, drawn out, soul sucking, pride swallowing affair wherein more attention is given to market research and dysfunctional corporate dynamics than my own clinical skill and performance as a resident. This is probably true in every field, but in Family Medicine it seems that the intersection between money and medicine is even more pronounced given the low reimbursement and thin margin of error for reaching your financial bottom line.

So the low reimbursement is probably the biggest CON, mostly because it makes it hard to practice medicine the way you would like. When people say, so what, they can still comfortably live off of $120,000 a year, they are right from that standpoint. What makes low reimbursement a CON is not the salary, its the way it limits how you practice medicine.

In summary, I agree with JP's post. I just wanted to clarify why low reimbursement is a CON. I'm optimistic that this will change. Some manner of healthcare reform is on the horizon, anyone who follows politics will tell you that, and historically primary care has always benefitted financially from healthcare changes which broaden public access to healthcare. (I'm not gonna debate this statement in this thread).

BTW, The complexity of medical issues you deal with on a day to day basis equals or exceeds every other specialty. Any Family Doc who tells you FP is not challenging is either lazy or flat out doesn't know what they are doing, and is blissfully unaware of the complexity in keeping people healthy and treating multiple diseases and organ systems in a holistic and ongoing manner.

Sorry for the long post. this is one of my favorite topics.

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Excellent post, thanks for that!

You sound like all the FP residents I work with. Of course, Im usually sitting around a table at a bar with them so their responses are a bit more...well, they use different language!

One thing that I have always found interesting, and you mentioned it as well, is the lack of inpatient responsibilities. Here in Philadelphia you wont find an FP directing the course of inpatient care unless the patient is in Med/Surg. Tele, unit...all goes to the medicine guys, regardless of how long the FP has been PCP for the patient.

Some of my FP friends are bothered by that whereas others are more than happy NOT to have the responsibility. Some of them went into FP so they could be outpatient docs only.

You sound like all the FP residents I work with. Of course, Im usually sitting around a table at a bar with them so their responses are a bit more...well, they use different language!

One thing that I have always found interesting, and you mentioned it as well, is the lack of inpatient responsibilities. Here in Philadelphia you wont find an FP directing the course of inpatient care unless the patient is in Med/Surg. Tele, unit...all goes to the medicine guys, regardless of how long the FP has been PCP for the patient.

Some of my FP friends are bothered by that whereas others are more than happy NOT to have the responsibility. Some of them went into FP so they could be outpatient docs only.

Again, good to read your response.

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I did an IM track intership, so I have a little more interest in the inpatient work than most. Most hospital CEO's and employers rather hospitalists do the inpatient work, I think, because they are better at adhering to protocols and they know what to document to get an inpatient stay reimbursed properly. But the hospitalist model is an inefficient one, and many tests get repeated during an inpatient stay that the PCP has already done. This tends to lead to longer stays.

I'm convinced that if FP's did their own hospital work, the average length of stay would decrease significantly. Corporate exec's don't necessarily see this. But really, most experienced FP's don't want the responsibility anymore, either. And, I also see many people go into FP specifically to be outpatient docs.

No. On average DOs who dont use OMM make far less then MDs. Patients wont make appointments with them, MDs wont talk to them and they cant write prescriptions. Hell, nurses wont even bang a DO if there is an MD around. Sad world.

For all the dumb $hit you post Riker, you are seriously asking this? Unbelievable.

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In general, are the below true??
1) On avg DO's that do FP make less than MD's that do FP if DO's don't do OMM. ( I've heard that about 90% of DO's don't do OMM. )
2) Patients won't make appointments with DOs. I don't get this one. How do DO in FP survive then?
3) What do you mean when you said "they can't write rxs"?
4) Nurses won't bang a DO if an MD is around? AHHHHHHH......j/k. hahah

In general, is this true??
1) On avg DO's that do FP make less than MD's that do FP if DO's don't do OMM. I've heard that about 90% of DO's don't do OMM.
2) Patients won't make appointments with DOs.
3) What do you mean when you said "they can't write rxs"?
4) Nurses won't bang a DO if an MD is around? AHHHHHHH......j/k. hahah

I would like clarification on the first 3.
Thanks

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NO its not true.

1. The payscale for an MD and DO is exactly the same. Regardless of which degree you hold, when you bill a patients insurance you are reimbursed the same amount. OMM can definately supplment your income

2. Patients will indeed make appointments with DOs. I have never met, or heard of a patient refusing to see the doctor because they were a DO. In fact, quite often I see the opposite where patients want to see DOs because of the OMM.

In general, are the below true??
1) On avg DO's that do FP make less than MD's that do FP if DO's don't do OMM. ( I've heard that about 90% of DO's don't do OMM. )
2) Patients won't make appointments with DOs. I don't get this one. How do DO in FP survive then?
3) What do you mean when you said "they can't write rxs"?
4) Nurses won't bang a DO if an MD is around? AHHHHHHH......j/k. hahah

I would like clarification on the first 3.
Thanks

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Reimbursement is exactly the same. FP's who do more procedures earn more money. OMM is billed as a procedure. You can definitely make more as a DO having the ability to perform and bill for OMM. Sometimes you have to fight with the insurance company to be properly reimbursed for the additional procedure code.

Alot of family docs are employees, thus don't have the incentive to do alot of procedures or OMM. They make a guaranteed amount of money no matter how much they do. (Or don't do.) Most of the family docs I see doing alot of OMM are in business for themselves, and own their own practice, so I have no doubt it pays well. These docs tend to be most efficient at running a tight ship and getting paid for everything they do.

I think most of the DO's who don't do OMM work within an employment model and receive a guaranteed salary, and have no incentive to maximize their reimbursement by taking the time to do alot of OMM. This is just an observation I have made during my residency. I don't have any hard data to back that up.

Seriously, why are people so worried about making Money, dont get me wrong, making money s not harmfull , but mixing it with your residency choice kills the spirit any "Aspiring" doctor should have, SHOULDnt you be more worried about joining a leftist organization hell bent on relieving back pain across Afirca.

The point is, you are, or might eventually, well maybe some day, it could just be in your dreams, become a Doktor, el preseidente los medicine, and you should feel blessed that chance, or GOD has granted you an oppurtunity to help your fellow man out, so you should not bicker about the very precepts of helping out too much, if you want too, then just maybe you should quit thinking about medecine as a career.

In general, are the below true??
1) On avg DO's that do FP make less than MD's that do FP if DO's don't do OMM. ( I've heard that about 90% of DO's don't do OMM. )
2) Patients won't make appointments with DOs. I don't get this one. How do DO in FP survive then?
3) What do you mean when you said "they can't write rxs"?
4) Nurses won't bang a DO if an MD is around? AHHHHHHH......j/k. hahah

I would like clarification on the first 3.
Thanks

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I really really hope this guy's trolling. If not I think he's in trouble

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